The Importance of the Gluteal muscles

Hi folks,

This is my first rehab/physio type post so please read it and hopefully you will learn something from it! In this post I intend to highlight the importance of a group of muscles that I feel are often overlooked; the Gluteals.

The Gluteals are seperated into 3 main muscles.

  1. Gluteus Maximus: which is the largest of the three and extends the hip
  2. Gluteus Medius: which is abducts and internally rotates the hip
  3. Gluteus Minimus: which is the smallest of the three and also abducts and internally rotates the hip

Lets take a more in depth look at each muscle.

Gluteus Maximus

Gluteus Maximus is one of the largest muscles in the body. It originates from the external iliac crest behind the posterior gluteal line, the dorsal surface of the sacrum, lateral margin of the coccyx and the fascia of gluteus medius and the erector spinae. It travels in a caudo lateral direction and inserts on the gluteal tuberosity of the proximal posterior femur and to the Iliotibial tract.  The Glute Max is a powerful extensor of the hip and also contributes to abduction. It also provides stability for the hip and knee joints during movement.

Gluteus Medius

Gluteus Medius lies underneath gluteus maximus. It originates from the external surface of the ilium between the anterior and posterior gluteal lines. It inserts onto the lateral surface of the greater trochanter of the femur. Gluteus Medius abducts and internally rotates the hip and also prevents against pelvic drop during walking.

Gluteus Minimus

Gluteus Minimus lies underneath both Gluteus Maximus and Medius. It arises from the external surface of the ilium between the inferior and anterior gluteal lines and it inserts on the anterolateral aspect of the greater trochanter of the femur. It functions like the Gluteus Medius (hip abduction/internal rotation/prevention of pelvic drop).

The gluteal muscles are involved in everyday movement as producers and stabilisers of movement at the hip joint. They contribute to movement by firing at the correct time to produce functional efficient movement. The correct firing pattern of the Gluteus Maximus is well documented during lower limb movement. The contralateral Erector Spinae fire first, closely followed by the gluteus maximus and then the hamstring during hip extension.   Consider that hip extension is a basic movement involved in all walking and running, therefore the correct function and firing pattern of the gluteus maximus is very important for everyday activity.

Gluteus Medius and Minimus are primarily stabilisers of the hip joint. They work together to provide rotational control of the leg during movement (which i will come back to later) and they also work together to produce hip abduction. Both muscles function for the same purpose and it is impossible to make one contract without contracting the other. During stance and movement these muscles prevent pelvic drop by maintaining a constant low grade contraction.

Gluteal dysfunction is very common within sport. I work with athletes and I regularly see them suffering from the same problems. Too many of our athletes dont understand how their bodies are designed to function and therefore dont know when they are actually dysfunctional. Commonly athletes suffer from three gluteal dysfunctions.

  1. An inability to contract the gluteals at the correct time to optimise movement
  2. An inability to contract the gluteals at all
  3. Hamstring dominance

Fortunately a skilled medical professional will easily be able to detect these problems and rectify them. Athletes who display any or all of the above conditions need re-education and proper motor learning so that the dysfunctional muscle can be taught to fire correctly as part of a chain of muscle that perform a movement or skill. Gluteal activation, Glute-hamstring dissociation and gluteal strengthening will correct these problems.

A very effective screening technique for picking up on gluteal dysfunction is the single leg squat. By observing a patient performing the single leg squat we can pick up any number of correct and incorrect joint movements. In this case it is easily visible if the patients glute med/min are working, as they control internal rotation during the movement. Consider this picture of an elite athlete, Ryan Giggs, displaying very poor rotational control (glute activation) during a single leg squat.

Observe how his left pelvis has dropped and his left knee is internally rotated and adducted. This displays poor glute med/min activation and function.

Bridging is another very useful screening tool for gluteal dysfunction. By observing a patient when bridging the therapist can assess the strength of gluteal contraction and whether or not the hamstrings are dominating the movement. This is done by actively palpating the glutes and hamstring during the exercise and assessing which muscles are providing the stability during the exercise. In this position it is easy for the therapist to encourage hamstring relaxation and gluteal activation by providing tactile stimulation (glute/hamstring dissociation).

The benefits of Gluteal training are plain for all to see. Happily contracting Gluteal muscles provide hip and knee stability during movement and they are important producers and controllers of forces in the human kinetic chain. Properly trained glutes will increase your running efficiency and overall strength and power in the posterior chain.

In my opinion, the gluteals are one of the most often overlooked muscles. Although in recent times i have noticed professional clubs incorporating gluteal training into their warm ups and prehab work. During a recent English Premier League fixture, the Manchester City players were seen facilitating Glute Med/Min by performing bodyweight squats with theraband tied around their knees. The importance of these muscles may be dawning on some people. Perhaps the Glutes (like Transverse Abdominus at the minute) are on the verge of becoming the next “sexy/fashionable” muscle to talk about! However in general there needs to be a conscious effort from therapists and fitness professionals to educate athletes/clients on the importance and benefits of proper gluteal function.  Only through education will we have any chance of changing the current ignorance towards a very important muscle group.

Please feel free to discuss this post using the comments section below. Until next time,

Dave.

9 thoughts on “The Importance of the Gluteal muscles

  1. Great article. I have an identical problem which has lasted for just over 2 years now. Have seen various specialists including podiatrist, chiro, osteo, sports massage and physio. My most recent physio is the only one who has managed to diagnose and has done some release on certain muscles on the weak side but still no luck at the moment as the problem keeps returning. I have an audible click on knee flexion and I know this is related to some kind of muscle imbalance due to the glute medius not firing properly atall. I think the TFL is firing first so there is no point in me doing rehab exercises everyday if the firing pattern is wrong. I need to correct the firing pattern somehow and then isolate glute medius/maximus. I used to have very strong hips but not now on my right side, no idea how it has happened. Do you know how ryan giggs corrected this problem??

    Many thanks,

    Matt

  2. Hi Matt,

    I suggest you take a look at my other post concerning hip mobility and really try to get the hip joint moving freely and properly. This in itself may help to alleviate some of your problems. After that to isolate Gluteus Medius you could perform clams with a theraband or squats with a theraband around the knees. Both of these exercises are excellent for recruiting Gluteus Medius. With regards to the firing pattern problem,more often than not, recruiting the underused muscle (gluteus medius/ maximus in this case) helps to correct the patterning problem. When the underactive muscle kicks in again then the pattern may resolve. Your physio should be able to perform soft tissue release of the tightened compensating structures and provide stimulation of the underactive muscles using exercise therapy.

    Hope this helps you,
    David

  3. Hi Dave,

    I am currently looking into research ideas for my MSc S&C dissertation project. I stumbled across a recent paper demonstrating that glute activation (low intensity) can lead to an acute increase in explosive power. I also do a bit of work with a professional football club, and as you said many clubs are incorporating activation work into warm-ups etc, and it baffles me how there is not more research on this topic. My idea was to use mini bands and form an activation protocol that increases resistance compared to just stretching, but remains applicable to field-based warm-ups.

    I an interested in hearing your thoughts, also do you know of any other resistance band exercises that target the glutes?

    Many Thanks
    Ollie

    • Hi Ollie,

      Thanks for readin and thanks for the comment. I think your activation protocol is a great idea. I have had similar ideas myself but havent implemented them properly. Team managers seem to think that every player messing about with theraband in a warm up is a load of nonsense.. I explained what i was trying to achieve but it was a no-go unfortunately! As regards other exercises to target the glutes i have seen protocols that involved this type of work. Basically it was a miniband that was attached to both legs above the ankles and the players went through a series of lunges, stepping patterns and shuffles, in an attempt to activate the glutes. To be honest though, since I wrote this article I have been doing alot of reading into movement patterns and muscle activation (Gray Cook’s work) and Im now of the belief that simply attaching added resistance in the form of a miniband wont really cut it. Its all about motor learning and patterning and how the CNS recognises patterns etc. I thin a really interesting study would something along the lines of ” the effect of a movement pattern based warm up vs a normal dynamic warm up”… would be interesting to see which lead to the greater results on performance or whatever variable you are measuring.. Slight bit of a tangent from the main question Ollie but that is where my thinking is at the minute! Feel free to drop me an email at davidmcgettigan87@gmail.com at any stage about any ideas you have or anything like that!

      Cheers,

      Dave

  4. Dear David,
    Excellent article. I am suffering from hamstring pain predominately in the left side but also a bit in the right side as well more recently. An experienced physio who treats my parents in the UK recommended I research Hamstring Gluteus medius/maximus imbalance as the possible cause for the pain. I am a professional tennis coach in the Caribbean and the injury has kept me out of work for the last 4 months. The injured started when doing many hours on the court in December and at first I thought it to just be a repetitive strain injury to my left hamstring.
    At first I didn’t consider it very serious and followed the normal procedure for muscle pulls of RICE and Ibuprofen, and also saw a physio and Chiropractor. Things didn’t improve at all after a month and then saw an orthopedic consultant who thought it was more like Adductor/Hamstring tendinitis. He gave me two cortisone injections into the groin and when that didn’t help I went on a week course of Prednisone. This also didn’t help. I have had an MRI scan of my left thigh which showed nothing unremarkable and an MRI of my lower spine and sacrum when I started experiencing similar pain in my right side. This also showed nothing unremarkable and no pinched nerves. I recently saw a top Orthopedic specialist in New York and also a Neurologist over there who didn’t think there was anything Neurologically wrong. I have also had the relevant blood tests done which show no inflammation in the blood. My hamstrings are flexible and have had a lot of deep tissue work over the last few months which also haven’t helped.
    After 4 months of rest and seeing also sorts of Doctors, Chiropractors, Physios, having Scans and receiving the above mentioned medication, I know a large number of injuries it is not but not much further in understanding what the exact diagnosis is. I was wandering if you think the pain could be related to a muscle imbalance and the gluteus muscles? Have you heard or seen similar symptoms in athletes that you have worked with?
    Many thanks,
    Kristian

    • Kristian,

      Many thanks for your kind words about the article. It sounds like you have had a rough time of it lately with your hamstring problems. In my opinion it sounds as though you have a muscle firing problem. What I mean by that is, some part of your hamstring or glutes is facilitated and the muscle is firing more than it should be which can cause a painful response. This is a problem with a specific movement pattern. If i were you I would look for a therapist who has trained in NKT (Neuro Kinetic Therapy) and in the SFMA (Selective Functional Movement Assessment) as you seem to have tried all of the other conventional options. NKT is an amazing therapy that I will be beginning to study in a few months time. It helps to normalize muscle firing patterns and also to switch muscles that have been ‘knocked offline’ on again! As of this moment in time, NKT is predominantly found only in the USA and Canada (the guy who developed the technique is from America and he has only taught these courses in USA/Canada). Hoping that my reply has been of some help to you,

      David.

  5. Thank you for such an interesting article. I am a very active, young at heart pensioner (or I was until 5 months ago!) Jan this year I suffered with a tight piriformis (not piriformis syndrome) due to overuse from constantly learning new dances (mainly sequence) and then teaching my husband followed by constantly practising over a course of 5 months. I had physio and was instructed to perform exercises by turning my knees outwards, this was to try to correct the same condition that Ryan Giggs displayed above. It was a disaster as I was told to perform this exercise “as many times as I could & as often as I liked”. Me being a dedicated person obviously did too much and following a week of intense inflammation which i treated with ice & rest i developed painful Trigger points which i dilligently treated and cured. following this i was advised to go to pilates where my instructor told me to perform the clam 10-15 times a day. 4 weeks later i dmeveloped very tight painful glutes medius which affected my hip joint. following treatment with an excellent sports massage therapist i joined aYoga class to help me relax as i was becoming very anxios & it was suggested that i do the bridge, to try to strengthen my glutes ( during this period of time i was suferring and could not go about my normal life which was walking, cycling dancing and generally socialising plus voluntary work. Again 3weeks later I developed very tight glute med plus glute min this time. I am still having massage (which has worked before and I know will get me right again) however I am distressed to know I have the same problem as Ryan Giggs and I just don’t know what to do to correct it, as both exercises recommended have had a disastrous affect on me and taken months to recover. I would like to add that I am normally very fit and have been told by physios and my therapist that I have very healthy flexible joints (which I know) but unfortunately because of my flexibility I do not recognise when I am overdoing activities until I have symptoms of overused muscles.if you receive this post I would be so very grateful if you could give me some advice or suggestion as to what I could do. As you will see by the above I am prepared to do any thing to help myself.

    • Hi Averil,

      It sounds like you have muscles that are wat we call “facilitated”, i.e. they are overworking and constantly “on” (piriformis / glute medius etc). They are facilitated for muscles that are “inhibited” i.e. muscles that are underworking all the time. It’s impossible to give you any answers via email as I would need to assess you properly in person. Search for a Neurokinetic Therapy Practitioner or an Anatomy in Motion Practitioner in your area and they should be able to help you out.

      http://www.neurokinetictherapy.com
      http://www.anatomyinmotion.co.uk

      Hope this helps,

      David.

  6. I’ve been experiencing chronic lower back & hip pain. After a good 2-3 hour hike in the mountains, my glutes (maximus) were very sore, and continued to be sore for the next week, as I continued to be active up & down stairs and lift weight. I noticed that I was feeling stronger and experiencing a significant reduction in back & hip pain, and attributed it to the strengthening of my glutes. This confirms it! I will continue to focus on strengthening these very important muscles! Thank you ~

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